Cabinet Presentation Personal Injury Protection. August 2011

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1 Cabinet Presentation Personal Injury Protection Tallahassee, Florida August

2 Types of Auto Insurance Systems No Fault 10 States Economic damages from injuries sustained in an auto accident are covered by each party s own insurance; the negligent party may be sued for additional funds to compensate for noneconomic damages after a specified threshold has been exceeded. 2

3 Types of Auto Insurance Systems Tort 38 States At fault drivers are liable for the economic and noneconomic damages they inflict on others. Choice 2 States and DC Drivers choose between differing types of auto insurance. 3

4 Auto Insurance Coverage Types Liability Coverage for all sums the insured is legally obligated to pay due to an accident Bodily Injury (BI) Provides coverage for death or serious and permanent injury to others when you are legally liable for an accident involving your automobile. Medical Pay (Med Pay) Provides coverage for medical treatment for the insured or resident family member resulting from an auto accident, regardless of fault, as well as any person occupying the covered auto. Personal Injury Protection (PIP) Provides coverage for medical benefits, lost wages and funeral benefits for insured or resident family member when injured in their own vehicle, in someone else s vehicle, as a pedestrian or as a bicyclist. Property Damage (PD) Coverage in the event that negligent acts or omissions of an insured result in damage or destruction of another s property. Uninsured Motorist (UM) Coverage provided to the insured, resident family members and any other person occupying the covered automobile for bodily injury resulting from an accident involving an uninsured or underinsured driver. 4

5 Auto Insurance Coverage Types Physical Damage Coverage for damage to your covered automobile and other related coverages Collision Coverage provided for damage caused by a collision with another vehicle or object Comprehensive Coverage for physical damage (excluding collision) or theft of the insured vehicle(e.g. theft, fire or hail damage) Towing Coverage for towing and road service for your covered automobile Rental Reimbursement Reimbursement for auto rental up to specified limits if you get into an accident with your own automobile and can no longer drive it. 5

6 PIP/No Fault lthistory in Florida 1972 Florida Enacts No Fault Law ($5,000PIPBenefit) 1979 PIP Benefit is Raised to $10, Mandatory Property Damage Liability Coverage ($10, Benefit) 2000 Statewide Grand Jury Findings 2001 Enhanced Fraud Protections Enacted Including Clinic Licensure and Limited Third Party Access to Crash Reports 2003 Further Anti fraud andlicensing Provisions 2007 PIP Sunsets, But is Re enacted during Special Session (with some reforms) 6

7 Number of Licensed Drivers Has Remained Stable Since Numb ber of Licensed Drivers (Millions) Data as of January 1st Source: Driver Demographic Reports from Florida Department of Highway Safety and Motor Vehicles ( 7

8 Frequency of Crashes Has Decreased Since Fre equency per 100 Licensed Drivers Year Source: Driver Demographic Reports and Traffic Crash Reports from Florida Department of Highway Safety and Motor Vehicles ( 8

9 Total PIP Benefits Paid Have Increased Significantly Since 2008 $2.5 in Year $2.0 Am mount of PIP Benefits Paid ($ $Billions) $1.5 $1.0 $0.5 $ Year Source: Report on Review of the 2011 Personal Injury Protection Data Call April 11, 2011 Data shown is for total payments for PIP benefits and excludes attributable expenses. 9

10 Number of PIP Related Lawsuits Has Increased Significantly Since ber of Lawsu uits (Thousa ands) Pending at Year End Settled During Year Num Year Source: Report on Review of the 2011 Personal Injury Protection Data Call April 11, 2011 Number of PIP related lawsuits where the insurer was the defendant 10

11 Top Five PIP States t Bodily Injury Limit State No Fault Limit (If mandatory) 1. Michigan Unlimited PIP $20,000 per person/$40,000 per accident 2. Florida $10,000 PIP limit N/A 3. New York $50,000 Limit $25,000 per person/$50,000 per accident 4. New Jersey $250,000 Standard Limit $15,000 per person/$30,000 per accident (A $15,000 Basic limit is available) for Standard Policy $10,000 per accident available as option for Basic Policy 5. Pennsylvania* $5,000 Medical Mdi lbenefits Only $15,000 per person/$30, per accident (Funeral expenses, wage loss, etc. available as additional optional coverages) Source for Rankings: Annual Statement 2010 Direct Written Premium from Statutory Page 14 for Private Passenger Auto No Fault (Personal Injury Protection) line of business. * Pennsylvania allows insureds a choice between a no fault and a tort system. 11

12 Actual PIP 6 Month Premium Quotes (For Selected Zip Codes in Top Five PIP States) $90 $80 $70 $60 $50 $40 $30 $20 $10 $0 $85 $52 $36 $34 $24 $26 $22 $17 $19 $ Tallahassee, FL Hialeah, FL Miami, FL Tampa, FL Taylor, MI * Detroit, MI * Lakewood, NJ Brooklyn, NY Phil., PA $10K Medical Only Phil., PA $5K Medical Only Cost of PIP Premium per 1,,000 in Coverage For Minimum Policy Allowed by State Source: Large national carrier s online quote tool for 25 year old single female, with no accidents/violations in last five years, and less than one year at current insurer at minimum or no BI limits. For states where occupation is used, Food Service. * $50,000 used as proxy for limit for Michigan since PIP coverage is provided on unlimited basis. 12

13 PIP Direct Pure Loss Ratio For Top Five PIP States 250% PIP Dire ect Pure Loss Ratio 200% 150% 100% 50% Florida Michigan New Jersey New York Pennsylvania 0% Calendar Year Source: Annual Statement Statutory Page 14 13

14 PIP Combined dloss Ratios Rti Source: Calendar Year Experience Reporting Form (Form OIR B1 308); 2010 is preliminary Only includes information from insurers that write 0.5% or more of the total industry wide written premium for that line of business of the preceding calendar year 14

15 Cumulative Rate Changes For Top Five Auto Insurers (Since 1/1/2009) Coverage STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY GEICO GENERAL INSURANCE COMPANY PROGRESSIVE AMERICAN INSURANCE COMPANY PROGRESSIVE SELECT INSURANCE COMPANY ALLSTATE INSURANCE COMPANY BI 40.0% 40.0% 33.0% 36.0% 46.3% PD 40.0% -6.0% -4.2% 2.3% 29.6% PIP 49.7% 72.2% 63.0% 48.5% 35.1% UM 52.4% -3.3% 48.7% 67.8% -7.4% MP -3.8% -1.9% -1.7% -0.2% 23.1% C OLL -15.9% -22.1% -19.8% -12.4% -24.7% COMP -7.2% -18.0% 80% -29.5% -16.6% 66% -26.3% Total: 26.0% 14.0% 19.0% 18.8% 11.5% Market Share: 19.9% 8.6% 5.2% 4.7% 4.5% Source: For filings implemented by insurers with effective dates for new business on or after January 1, 2009; Based on data submitted in the Rate Collection System as of August 1,

16 Comparison of PIP Premium Over Time for Miami Insured $1,000 $900 $800 Annua al PIP Premium m $700 $600 $500 $400 $300 $200 $100 Married 40 year old female Unmarried 25 year old male $0 1/1/2005 1/1/2006 1/1/2007 1/1/2008 1/1/2009 1/1/2010 1/1/2011 Effective Date of Policy Source: Annual PIP premium for Miami zip code for a large national carrier. Assumes neutral risk score, no tickets/accidents, anti lock brakes and automatic front seat belts. 16

17 Comparison of PIP Premium Over Time for Tampa Insured $700 $600 l PIP Premium m Annua $500 $400 $300 $200 Married 40 year old female Unmarried 25 year old male $100 $0 1/1/2005 1/1/2006 1/1/2007 1/1/2008 1/1/2009 1/1/2010 1/1/2011 Effective Date of Policy Source: Annual PIP premium for Tampa zip code for a large national carrier. Assumes neutral risk score, no tickets/accidents, anti lock brakes and automatic front seat belts. 17

18 Tampa Continues to Lead the State in Staged Accident Questionable Claims Source: NICB, Staged Accidents Analysis Florida , released April 20, 2011 ( releases/florida staged accident qc report) 18

19 Licensed Driv vers Claims Open/Recorde ed Per 1,000 Claims Opened/Recorded By Region Per 1,000 Licensed Drivers South Florida Southwest Florida Tampa/St. Petersburg Central Florida Northeast Florida Year Source: Claims from Report on Review of the 2011 Personal Injury Protection Data Call April 11, 2011 and licensed drivers from Driver Demographic Reports from Florida Department of Highway Safety and Motor Vehicles ( 19

20 PIP Fraud Referrals Have Increased Significantly Since ,000 7,000 6,699 Numb ber of PIP Refe errals 6,000 5,000 4,000 3,000 2,000 2,628 3,159 3,608 3,151 3,615 5,543 1, Fiscal Year Source: Florida Department of Financial Services, Division of Insurance Fraud 20

21 Almost 50% of Total Referrals Are Now PIP Related Perc centage of Ref ferrals that ar re PIP Related 60.0% 50.0% 40.0% 0% 30.0% 20.0% 0% 10.0% 0.0% 23.0% % % % % % % Fiscal Year Source: Florida Department of Financial Services, Division of Insurance Fraud 21

22 The Average Provider Charges Per Claim Continue to Increase $14,000 Average Provid der Charge pe er Claim $12,000 $10,000 $8,000 $6,000 $4,000 $2,000 National Average Provider Charges per Claim National Average Provider Charges per Claim (w/o FL) Florida Average Provider Charges per Claim $ Source: Report on Review of the 2011 Personal Injury Protection Data Call April 11,

23 Average Procedures Per Claim Have Increased Significantly Since Aver age Number of Procedures per Claim National Average Lines per Claim National Average Lines per Claim (w/o FL) Florida Average Lines per Claim Source: Report on Review of the 2011 Personal Injury Protection Data Call April 11,

24 Average Procedures Per Bill Have Also Increased Since Aver rage Number of Procedures per Bill National Average Lines per Bill National Average Lines per Bill (w/o FL) Florida Average Lines per Bill Source: Report on Review of the 2011 Personal Injury Protection Data Call April 11,

25 SB 1930/HB 1411 Summary (Senator Bogdanoff and Representative Boyd) Enhanced tools to fight fraud Improved investigation of claims for No Fault benefits New guidelines for handling fraudulent tno Fault claims New guidelines for submission of bills to insurer Reimbursement criteria for No Fault benefits New guidelines for demand letters Allows for the creation of Preferred Provider PIP networks 25

26 SB 1694/HB 967 Summary (Senator Richter and Representative Horner) Authorizes the use of arbitration to resolve disputes Grants exclusive original jurisdiction to circuit courts to hear challenges to PIP arbitration decisions Caps attorney fee awards in disputes under the No Fault Law Bars use of a contingency risk multiplier in determining fee awards in No Fault cases Creates a fee schedule based on Medicare Part B Durable Medical Equipment andcare rendered by Clinical Labs Creates a fee schedule for care provided at ambulatory surgical centers limited to 80 percent of the workers compensation fee schedule when not reimbursable under Medicare Part B Requires insureds who are seeking PIP benefits to comply with all terms of the insurance policy, including submitting to an examination under oath (EUO) and allows for the EUO to be recorded Sets standards for the EUO process 26

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